Physicians in training at high risk for depression

BOSTON, MA - Physicians in training experience higher rates of depression when compared with the general public. However, the estimated prevalence of this disorder among resident physicians has varied substantially between studies. New research from Brigham and Women's Hospital (BWH) finds that 28.8 percent of trainees screen positive for depression during their residency. The findings are published in the December 8 issue of JAMA.

"These findings highlight an important issue in graduate medical education," said corresponding author Douglas A. Mata, MD, MPH, a resident physician in pathology at Brigham and Women's Hospital and clinical fellow at Harvard Medical School. "The prevalence of depression is much higher than in the general population."

Researchers conducted a meta-analysis involving fifty-four studies including 17,560 physicians in training that assessed for depressive symptoms, and were published in the peer-reviewed literature between January 1963 and September 2015. The researchers noted that their findings were similar across specialties and countries, suggesting that the underlying causes of depression were common to the residency experience.

"The increase in depression, found over the five decades covered by the study, is surprising and important, especially in light of reforms implemented to improve the residency experience," said co-author Srijan Sen, MD, PhD, a psychiatrist and epidemiologist at the University of Michigan.

The development of depression in early adulthood has been shown to increases the risk of future episodes of depression and other medical illnesses, most notably heart attacks and strokes. These findings indicate that the long-term health of resident doctors may be at risk. Depression among residents also affects patients, as previous research has established links between physician depression and lower quality care.

"Our findings provide a more accurate measure of the prevalence of depression in this group, and we hope that they will focus attention on factors that may negatively affect the mental health of young doctors, with the goal of identifying strategies to prevent and treat depression among graduate medical trainees," Mata said.

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Other coauthors of the JAMA study included Marco A. Ramos, MPhil, MSEd, Yale School of Medicine; Rida Khan, BS, Baylor College of Medicine; Narinder Bansal, PhD, and Emanuele Di Angelantonio, MD, PhD, University of Cambridge; and Constance Guille, MD, MS, Medical University of South Carolina.

This research was supported by the U.S. Department of State Fulbright Scholarship, the National Institutes of Health R01MH101459, and National Institutes of Health Medical Science Training Program TG 2T32GM07205.

Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits, nearly 46,000 inpatient stays and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $600 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.

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